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The American Fertility Association Blog

What do male frogs with eggs, genital defects and your everyday products have in common?

July 20, 2009 - Monday
Posted by admin

By:  Heather Sarantis

Yesterday as I trolled the New York Times, I was excited to see that Nicholas Kristof was at it again. I am a fan of his under normal circumstances, but his recent columns focusing on hormone (or endocrine) disruptors just really hit the nail on the head.

Hormone disruptors are substances not naturally found in the body that interfere with the production, release, transport, metabolism, binding, action or elimination of the body’s natural hormones. They can scramble messages that natural hormones normally transfer between cells.

They are used in numerous everyday products, including plastic bottles, cosmetics, the lining of food containers, medical devices, pesticides and many others. And the vast majority of people are being exposed to them-some tests showing more than 90% of the people tested by the Centers for Disease Control having certain hormone disruptors in their bodies.

Kristof’s columns highlight several important trends. First, we are seeing evidence of hormone disruptors in wildlife, such as male fish developing eggs, which means their use is widespread enough that they are dispersing into the environment. Second, we are seeing evidence in humans - for example, baby boys developing genital malformations or young girls entering puberty prematurely, which means we are putting ourselves and our children at risk for reproductive and other health problems.

Researchers have known for years that hormone disruptors may cause health problems. For example, Bisphenol A, a hormone disruptor found in some plastic bottles (including some baby bottles), was known to have potential health problems as early as the 1930’s.  But scientific consensus about chemical safety-and subsequent regulation-is often a tough row to hoe. Last month marked a big success in the struggle - the Endocrine Society released a ground breaking report stating that exposures to endocrine disrupting chemicals are a growing threat to human health and well-being. Recognition from professional societies such as this is critical in tipping the scales toward better safety regulation of chemicals, and many of us who work on chemical safety applaud the Endocrine Society for taking a bold stand on this issue.

So, what do hormone disruptors mean in everyday terms? If you are reading this blog, you are likely either thinking about having children or are several months or even years into trying have children. This is a good time to be learning about these chemicals.  What a woman is exposed to throughout her life, especially during pregnancy, can have long-term impacts on her baby’s health. There are too many hormone disruptors, and too many health risks from exposure to list them all here, but they can increase risk for a wide range of reproductive health problems, such as impaired fertility or infertility, polycystic ovarian syndrome, uterine fibroids, endometriosis, miscarriage, shortened lactation and breast cancer.  For a more complete understanding of these issues, see Girl, Disrupted: Hormone Disruptors and Women’s Reproductive Health.
No formula currently exists that can determine the exact effects hormone disruptors will have on a person’s health. Research indicates that the effects depend on the potency and dose of the chemical, the timing of the exposure (especially if exposure happens during pregnancy), and overall health. Taking good care of your general health is important, and other ways to protect your and your potential future babies’ health include:

1. Support policies to prevent exposure to hormone disruptors and other chemicals that have not been proven safe. Current standards for chemical use do not adequately protect us. New national policies are needed to identify and phase out harmful chemicals and to require that safer substitutes be used.
2. Use healthier products when possible. There are many easy, affordable and simple changes anyone can make at home to reduce their exposure to environmental contaminants. For ideas on how to make these changes, please see www.womenshealthandenvironment.org.

Heather Sarantis is the Women’s Health Program Manager at Commonweal/Collaborative on Health and the Environment. She is the author of the women’s health and environment toolkit, works on the Campaign for Safe Cosmetics and does many other things to help people reduce the exposure to harmful chemicals.

Categories
Endometriosis • Family Building • Fertility • Fertility and the Environment • Infertility • Miscarriage • PCOS • Pregnancy Loss • Reproductive Health

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Say Yes to the Dress - And To Your Fertility

July 9, 2009 - Thursday
Posted by admin

My daughter Caitlin and I routinely watch a TV show on cable called “Say Yes to the Dress”.  This is not the most comfortable show for me to watch, given that I’m an, ahem, divorced 53 year old, because it chronicles the buying angst of brides to be at Kleinfeld’s - The Most Famous Wedding Dress Emporium of Modern Times. 

You know, it’s funny.  My own mother did not get married in a wedding dress.  She married my dad on an army base in Maryland during WWII while he was on leave from the Pacific, wearing a blue skirt suit and a smile.  What’s ironic about that is, my mom’s two sisters both had big weddings.  They wore gowns that had “mermaid tails”  - (as I’ve learned from watching “Yes”), and accordion players, and lots of guests, and some kind of kosher food that I don’t know what it was that they served in the forties.  But in retrospect, you know what my mom’s sisters didn’t have that my mother did?  Amazing, everlasting, real love. 

My mom didn’t get the big dress.  But she got the big love.

Also, it would appear that my mom got PCOS.  Of course it was never diagnosed in those days, but it is pretty obvious to me now, what the deal was for her then.  She didn’t get pregnant for 14 years and had basically decided that the whole mother thing wasn’t in the cards for her.  Like so many of her generation (they were called The Greatest Generation, did you know that?), my mom just sucked up whatever obstacles life threw at her . She persevered and chose a great life for herself and for my dad too, despite any disappointments that she might feel. 

And then out of nowhere, the way it sometimes, every now and then happens for women with pco, she found herself pregnant.  Like so many women with this lousy disorder who never get a period she didn’t realize she was pregnant for five months, and then a doctor simply felt her belly and told her she had “ a little bun in the oven.” 

My parents were very lucky.  Their marriage would have survived forever, even with no kids.  Unfortunately, my dad died young, at 46, but my mom survived that too.

I don’t know.  Maybe it’s my generation and the ones that followed us.  Maybe not.  But you would have to live on another planet to not see the toll that infertility takes on married couples today.  I don’t know why but in these crazy times, in this crazy world, it seems like marriages don’t persevere as well as they did in generations past, especially in the face of bone crushing heartache.  I don’t know if that’s a better or a worse fate ( I really don’t) but I do know that in this day and age we have so many more choices than those that came before us and therefore, so many more disappointments. 

One more treatment to try, one more possibility for adoption.  On and on, seemingly without end. 

No end in sight.  But for many, no baby either.

I don’t really know why.  But I do know that the divorce rate seems to be higher for those who have gone through infertility treatment, resolved or not, than for the general population in our country. 

So here’s the deal.  The AFA will be talking a lot about infertility prevention for couples, and especially for newlyweds, over the next several months and into 2010.  Of course, we are always here for people when they are in the thick of it.  But if we can help prevent it?  We want to try to do that. 

That’s a good thing, and it’s important to us. 

The AFA is launching an initiative specifically geared towards young men and women who have fallen in love, and chosen to marry.  lt hits a little close to the bone for me and I hope it does for you too.  Like everything else that we at The AFA do, this one counts. 

So I hope I can count on you when I call.

Corey
Ben and Ruth’s kid      

Categories
Adoption • Fertility Preservation • Infertility • PCOS

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Green Eyes

June 26, 2009 - Friday
Posted by Corey

My dogs are people magnets.  I have two, Cabo Lucas, a mixed breed that we adopted out of a shelter in Mexico; he had been hit by a car and lost a leg, I adopted him when Dubya was president and I used to get a kick out of the fact that my furry Mexican wetback had no green card.  My other nut job is a maniacal cocker spaniel named Coco Chanel; she got a hair cut yesterday and lost her auburn curls, her beautiful green eyes are more prominent now.  She’s a shelter dog too, I tell all my friends in the adoption world that I have one domestic and one international adoption and they indulge me in my story without reminding me that dogs are not children.

The three of us were out for a walk this morning and a little girl stopped me to pet my dogs - Coco is skittish but I let her warm up to the little girl’s hand.  A teenage girl was with the little one.  I took one look at her and knew without a doubt, PCOS.  Like most girls, and women, with PCOS, this 16 year old was trying very hard to be invisible.  Overweight, a navy blue hoodie, jeans, dirty scuffed sneakers, a monotone look and voice.  She had acne but what really got to me was the male pattern baldness and the five o’clock shadow that she couldn’t hide above her upper lip.  But you know what else she had?  She had the same shade of green eyes as Coco - seriously - riveting eyes.

I didn’t know what to do.  In my work at The AFA I have spoken to scores of young women over the years who also had pco and had never heard the words before.  No, of course I’m not a doctor, and I can’t make a street corner diagnosis.  But still.  I felt so torn, in my mind I kept going back and forth.  Do I have the right to talk to her about this, without an invitation?  Do I risk making her feel worse?  Do I risk ruining her day?  But in the end, I chose to talk to her because I couldn’t bear the thought of her not knowing the truth about herself.

I was more gentle than I knew I know how to be before my first cup of morning coffee.  “Do you know that you may have pcos?  Have you heard that term before?” She was clearly embarrassed and I went on to tell her that I have it too.  I told her that I lost 70 pounds by eating low carb foods and exercising and sent her to http://www.atkinscenter.com to teach her how to do it.  I told her how I had eradicated the other life sucking symptoms of pco from my existence and also that I was a mom.  I told her my name and address, and that she could borrow my work out tapes.  I told her what she had, but mostly what I told her was that that she also had hope. 

Yes, she already knew that she had PCOS.  But the hope piece?  That she didn’t know.  She had been given a prescription but not a game plan.  When I told her she could be a mom someday, her beautiful eyes smiled.

Then I went home and had a cuppa, and turned on my computer, and started my day.  Dogs at my feet, I couldn’t stop smiling either. 

Corey Whelan
Program Director
The American Fertility Association

Categories
PCOS

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Pretty Woman

June 1, 2009 - Monday
Posted by admin

By: David Kreiner, M.D.


“We at The AFA have received a large number of emails from women who are confused by Kate Gosselin’s diagnosis of PCOS because, in their eyes, she is simply too pretty to have it.  Many people seem to have the misconception that a woman with PCO is doomed to a lifetime of unattractiveness.  AFA blogger, David Kreiner, M.D., has written about PCOS today in an effort to further educate women about this disorder” - The AFA staff

Polycystic Ovary Syndrome (PCOS) is a condition in which a woman’s hormones are out of balance.  It can cause problems with your periods and make it difficult to get pregnant.  PCOS may affect the way you look and can be associated with a variety of health problems including diabetes, hyperlipidemia and hypertension.

PCOS is the most common hormonal disorder of reproductive age women, occurring in over 7% of women at some point in their lifetime.  It usually develops during the teen years.  Treatment can assist women attempting to conceive, help control the symptoms and prevent long term health problems.

The most common cause of PCOS is glucose intolerance resulting in abnormally high insulin levels.  If a woman does not respond normally to insulin, her blood sugar levels rise triggering the body to produce more insulin.  The insulin stimulates your ovaries to produce male sex hormones called androgens.  Testosterone is a common androgen and is often elevated in women with PCOS.  These androgens block the development and maturation of a woman’s ovarian follicles preventing ovulation resulting in irregular menses and infertility.  Androgens may also trigger development of acne and extra facial and body hair.  It will increase lipids in the blood.  The elevated blood sugar from insulin resistance can develop into diabetes.

Symptoms may vary but the most common are acne, weight gain, extra hair on the face and body, thinning of hair on the scalp, irregular periods and infertility.

Ovaries develop numerous small follicles that look like cysts hence the name polycystic ovary syndrome.  These cysts themselves are not harmful but in response to fertility treatment can result in a condition known as Hyperstimulation syndrome.  Hyperstimulation syndrome involves ovarian swelling, fluid accumulating in the belly and occasionally around the lungs.  A woman with Hyperstimulation syndrome may become dehydrated increasing her risk of developing blood clots.  Becoming pregnant adds to the stimulation and exacerbates the condition leading many specialists to cancel cycles in which a woman is at high risk of developing Hyperstimulation.  They may also prescribe aspirin to prevent clot formation. 

These cysts may lead to many eggs maturing in response to fertility treatment also placing patients at a high risk of developing a high order multiple pregnancy.  Due to this unique risk it may be advantageous to avoid aggressive stimulation of the ovaries unless the eggs are removed as part of an in vitro fertilization procedure.

A diagnosis of PCOS may be made by history and physical examination including an ultrasound of the ovaries.  A glucose tolerance test is most useful to determine the presence of glucose intolerance and diabetes.  Hormone assays will also be helpful in making a differential diagnosis.

Treatment starts with regular exercise and a diet including healthy foods with a controlled carbohydrate intake.  This can help lower blood pressure and cholesterol and reduce the risk of diabetes.  It can also help you lose weight if you need to.

Quitting smoking will help reduce androgen levels and reduce the risk for heart disease.  Birth control pills help regulate periods and reduce excess facial hair and acne.  Laser hair removal has also been used successfully to reduce excess hair.

A diabetes medicine called metformin can help control insulin and blood sugar levels.  This can help lower androgen levels, regulate menstrual cycles and improve fertility.  Fertility medications, in particular clomiphene are often needed in addition to metformin to get a woman to ovulate and will assist many women to conceive.  The use of gonadotropin hormone injections without egg removal as performed as part of an IVF procedure may result in Hyperstimulation syndrome and/or multiple pregnancies and therefore one must be extremely cautious in its use.  In vitro fertilization has been very successful and offers a means for a woman with PCOS to conceive without a significant risk for developing a multiple pregnancy especially when associated with a single embryo transfer.  Since IVF is much more successful than insemination or intercourse with gonadotropin stimulation, IVF will reduce the number of potential exposures a patient must have to Hyperstimulation syndrome before conceiving.

It can be hard to deal with having PCOS.  If you are feeling sad or depressed, it may help to talk to a counselor or to others who have the condition.  Ask your doctor about support groups and for treatment that can help you with your symptoms.  Remember, PCOS can be annoying, aggravating even depressing but it is fortunately a very treatable disorder.

Sincerely,

David Kreiner, M.D.
Do Live in California?

To learn more about PCOS and how to control it, along with other steps you can take to prevent infertility, be sure to attend The AFA’s FREE Manicures & Martinis Infertility Prevention Series, which is coming to San Francisco and Laguna Niguel.  Enjoy complimentary manicures and martinis and learn about the reality of the biological clock, how STD’s can compromise your fertility, and how certain environmental toxins can jeopardize your ability to conceive a child. 


Manicures & Martinis San Francisco
Nova Nail Spa
811 Mission Street in San Francisco
Tuesday, June 9th, 6:00-7:30 PM
RSVP with Vivian:  [email protected] or 646-861-3226
More Details


Manicures & Martinis Laguna Niguel
Accent On Nails
28121 Crown Valley Parkway in Laguna Niguel
Tuesday, June 16th, 6:00-7:30 PM
RSVP with Vivian:  [email protected] or 646-861-3226
More Details

Categories
Fertility Drugs • Infertility • IVF • Ovulation • PCOS • Pregnancy

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Kate Gosselin Has PCOS and It’s None of Your Business

May 28, 2009 - Thursday
Posted by admin

May 27, 2009
11:30 p.m.

I’ve successfully avoided watching Jon & Kate plus 8 since the series started.  Yesterday, I wasn’t so lucky.  My daughter Caitlin came home from school dying to watch the show because her middle school - middle school!  - was all abuzz about the infidelity angle and she wanted to see what the deal was.  So last night, along with about half the population of the United States, I tuned in. 

Oy vey.  Now I get why I avoided it so stringently for so long. 

According to Wikpedia, Kate has pcos, the same diagnosis as me.  I didn’t know that.  Women with pco are very inclined towards hyperstimulation syndrome and multiple births and since Kate did IUI’s, not IVF, she was way more likely to conceive high order multiples, which she did.  Just like me.  I talk a lot about my twins in this blog space but the truth is, Connor and Caitlin are not twins.  They are surviving triplets.  So the high order multiple thing really flips me out.  And that’s why I’ve avoided this particular show for so long.  Anything that glorifies, and therefore misrepresents multiple birth, truly upsets me.

On top of that I am not a fan of reality TV.  I am not a shy person by nature.  But this voyeuristic need to see all, and this self focused need to show all, totally baffles me.  Why does everyone need to know, and see everything? And most importantly, for crying out loud, what about your kids?  No matter what the potential financial gain might be, what you put out there for the world to see, frankly, gets seen by the world!  And children are often the collateral damage of their parent’s need to show and tell their whole lives for all the world to see. 

So this is where it all lands for me.  These very real people, Jon, Kate, and their children, whose names are impossible to find on line, (what does that tell you?) are a family. 

These heartbreakingly adorable children were clearly wanted, and their parents worked very hard to conceive them.  So please. Remember why you had them, and protect them. 

Unfortunately, parents can’t always be trusted to do right by their children.  We all know that. 

Laws must be put in place, now, that eliminate the possibility that children can be exploited through their participation on reality TV shows. 

Life is hard enough.  Having your life plastered on a national stage without your consent is no way to grow up, no matter how you were conceived.

Corey Whelan
Program Director

Do Live in California?

To learn more about PCOS and how to control it, along with other steps you can take to prevent infertility, be sure to attend The AFA’s FREE Manicures & Martinis Infertility Prevention Series, which is coming to San Francisco and Laguna Niguel.  Enjoy complimentary manicures and martinis and learn about the reality of the biological clock, how STD’s can compromise your fertility, and how certain environmental toxins can jeopardize your ability to conceive a child. 


Manicures & Martinis San Francisco
Nova Nail Spa
811 Mission Street in San Francisco
Tuesday, June 9th, 6:00-7:30 PM
RSVP with Vivian:  [email protected] or 646-861-3226
More Details


Manicures & Martinis Laguna Niguel
Accent On Nails
28121 Crown Valley Parkway in Laguna Niguel
Tuesday, June 16th, 6:00-7:30 PM
RSVP with Vivian:  [email protected] or 646-861-3226
More Details

Categories
Infertility • IUI • IVF • PCOS

(13) Comments • (1) Trackbacks • Permalink



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